Are some diseases more neglected?
Some good examples of neglected diseases are Chagas' disease, Guinea worm, leprosy, lymphatic filariasis and onchocerciasis. These affect a large number of people in poor and developing countries. They are "neglected' because the donor agencies from the developed world have limited interest in them. Unfortunately, with more emphasis being on the big three killer diseases such as aids, tb and malaria and emerging and re-emerging diseases like Ebola, West Nile virus and Nipah virus, less donor money is available for the neglected diseases. After all, global funds are made up of donor money and are cash limited. If more money is given to one, less money is going to be available for the other.

Why focus on neglected diseases?
If money were spent on areas where success is more likely and not where success is less likely, millions more people would benefit and much disablement would be prevented. These neglected diseases are easy to control: the public health imperative here is simply to stop transmission. This is far cheaper and also in accordance with public health principles.

By ignoring these diseases, policy makers are forgetting scientific and operational evidence that interventions against "other diseases' are very effective. Many of the world's poorest people remain afflicted or are at risk from this group of diseases, though they need not be. By concentrating on so few agents, current policies perpetuate inequity, disrupt health finance policies, divert human resources from achievable goals, and deny opportunities for impoverished health systems to improve. Investing in neglected diseases would also strengthen the health system. Funds should be provided for both broad health sector support and disease-specific interventions.

By doing this, is success in controlling neglected diseases assured?
There are sufficient examples to prove that this works. Lymphatic filariasis has been removed from China, Chagas' disease from five South American countries; onchocerciasis from West African countries and Guinea worm from India and Pakistan. Neglected diseases are easier to control as they are transmitted by stable pathogens, which do not mutate easily. It is cost-effective, the estimated annual rates of return on investment being in the order of 14 to 30 per cent. For example, onchocerciasis control in West Africa has been described by the World Bank as one of the most effective investments in any development sector. Likewise, each us $1 invested in control of Chagas' disease in Brazil, and lymphatic filariasis in China, has produced returns of us $7